<!DOCTYPE html>
<html>

<head>
    <meta charset="utf-8">
    <title>枣庄学院2011级统一退款名单填写</title>
    <link rel="stylesheet" href="https://cdn.staticfile.org/twitter-bootstrap/3.3.7/css/bootstrap.min.css">
    <script src="https://cdn.staticfile.org/jquery/2.1.1/jquery.min.js"></script>
    <script src="https://cdn.staticfile.org/twitter-bootstrap/3.3.7/js/bootstrap.min.js"></script>
</head>
<style>
    div.form-group input {
        color:black;
    }
</style>

<body>

    <div class="container">

        <h2 style="margin-top:32px; text-align: center">枣庄学院2011级统一退款名单填写</h2>

        <form role="form" method="post" action="refund.php">
            <div class="form-group">
                <label for="num">学号：</label>
                <input type="text" class="form-control" name="num" placeholder="请输入学号" required>
            </div>
            <div class="form-group">
                <label for="name">姓名：</label>
                <input type="text" class="form-control" name="name" placeholder="请输入姓名" required>
            </div>
            <div class="form-group">
                <label for="ccb">建行借记卡号：</label>
                <input type="text" class="form-control" name="ccb" placeholder="请输入学号" required>
            </div>
            <div class="form-group">
                <label for="iccb">非建行借记卡号<span style="color:aquamarine">(选填)</span>：</label>
                <input type="text" class="form-control" name="iccb" placeholder="请输入非建行借记卡号">
            </div>
            <div class="form-group">
                <label for="openBank">开户行<span style="color:aquamarine">(选填)</span>：</label>
                <input type="openBank" class="form-control" name="openBank" placeholder="请输入开户行">
            </div>
            <div class="form-group">
                <label for="grid">年级专业班级：</label>
                <input type="text" class="form-control" name="grid" placeholder="年级专业班级" value="2011级机械设计制造及其自动化专业本科1班">
            </div>

            <button type="submit" class="btn btn-primary">提交</button>
            <button type="reset" class="btn btn-default">重置</button>
        </form>

        <div style="color:red; margin-top:20px">
            <p><span>注意:</span></p>
            <p><span>1.以上信息全部设置为文本格式,左对齐,汉子之间无间隔!</span></p>
            <p><span>2.非建行借记卡一定注明开户行</span></p>
            <p><span>3.如果你填写了非建行借记卡一定填写开户行</span></p>
        </div>

    </div>

</body>

</html>